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find Keyword "虎口挛缩" 3 results
  • 微型外固定支架在虎口外伤急诊治疗中的应用及疗效

    目的探讨微型外固定支架在急诊治疗虎口外伤中的应用及临床疗效。 方法2009年2月-2011年6月,收治虎口外伤患者34例。男21例,女13例;年龄18~65岁,平均31.4岁。致伤原因:机器冲压伤15例,重物压砸伤12例,切割伤5例,爆炸伤2例。受伤至入院时间20 min~6 h 30 min。按创伤程度及范围,26例为简单损伤,8例为复合性损伤。急诊清创后一期微型外固定支架开大虎口或联合虎口“Z”字成形治疗,复合性损伤者二期行皮瓣修复。 结果术后1例发生针道感染,经对症处理后愈合;其余患者切口均Ⅰ期愈合,复合性损伤患者皮瓣及供区植皮均顺利成活。31例获随访,随访时间5~14个月,平均7.5个月。末次随访时虎口开大角度为65~95°,平均80°。拇指指间关节纹尺侧点与示指掌指关节桡侧点距离为4.0~5.5 cm,平均4.8 cm;按顾玉东等的评价方法评价,获优19例,良10例,差2例,优良率达93.5%。 结论在虎口外伤急诊治疗中,采用微型外固定支架开大虎口,手术操作简便,损伤小,避免了虎口挛缩的发生。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • UPPER LIMB FREE FLAP FOR REPAIR OF SEVERE CONTRACTURE OF THUMB WEB AND ONE STAGE RECONSTRUCTION OF INDEX FINGER ABDUCTION

    ObjectiveTo evaluate the effectiveness of the upper limb free flap for repair of severe contracture of thumb web, and one stage reconstruction of the index finger abduction. MethodsBetween March 2007 and June 2011, 16 cases of severe contracture of thumb web and index finger abduction dysfunction were treated. There were 14 males and 2 females with an average age of 29 years (range, 16-42 years). All injuries were caused by machine crush. The time between injury and admission was 6-24 months (mean, 10 months). The angle of thumb web was 10-25° (mean, 20°), and the width of thumb web was 15-24 mm (mean, 22 mm). After scar relax of the thumb web, the defect size ranged from 6 cm × 4 cm to 8 cm × 6 cm; the upper limb free flap from 7 cm × 5 cm to 9 cm × 7 cm was used to repair the defect, index finger abduction was simultaneously reconstructed by extensor indicis proprius tendon transfer. The donor site was repaired with skin grafting. ResultsAll the flaps and skin graftings survived after operation and incisions healed by first intention. Fourteen patients were followed up 6-12 months (mean, 9 months). The flap appearance was satisfactory. The two-point discrimination was 6-9 mm (mean, 7 mm) after 6 months. The angle of thumb web was 85-90° (mean, 88°). The width of thumb web was 34-52 mm (mean, 40 mm). The abduction and opposing functions of thumb and abduction function of index finger were both recovered. Conclusion A combination of the upper limb free flap for severe contracture of thumb web and one stage reconstruction of the index finger abduction for index finger abduction dysfunction can achieve good results in function and appearance.

    Release date:2016-08-31 05:39 Export PDF Favorites Scan
  • CLINICAL APPLICATION OF GROIN SKIN AND ILIAC BONE COMPOSITE GRAFT IN CONTRACTURE OF FIRST WEB SPACE AND RECONSTRUCTION OF POLLICIS OPPONENS FUNCTION

    Objective To investigate the therapeutic effects of the groin skin and iliac bone composite graft on the repair of severe contracture of the first web space and one-stage reconstruction of the pollicis opponens function under the condition of no ideal muscle or tendon used. Methods From July 2003 to February 2006, 5 patients (4 males, 1 females; age range, 2038 years) with severe contracture of the first web space with loss of the pollicis opponens function were treated by the groin skin and iliac bone composite graft, with the clinical observation performed. The defect was caused by a crush injury in 3 patients, by an explosion injury in 1 patient, and by awrist joint mutilation injury in 1 patient. They all had been treated by operation at least once with a disease course of 6-24 months. The width and the angle of the first web space was 18 mm and 20° on average. Results The followed-up for 612 moths revealed that all the flaps had a success. The pedicle of the groin skin and iliac bone composite graft was cut off after 3 weeks, and 8 weeks later there was a bone union between the imbedded bone block and the first and second metacarpal bones. There was no evidence that the imbedded bone block was deformed or absorbed. The width of the first web space was augmented by an average of 32 mm, the angle of the first web space was augmented by an average of 60°. The pollicis opponens function recovered. Conclusion It is relatively simple and reliable to repair the contracture of the first web space and reconstruct the pollicis opponens function in one-stage usingthe groin skin and iliac bone composite graft.

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
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